• Title/Summary/Keyword: 경부목

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Expression of Decidual Natural Killer (NK) Cells in Women of Recurrent Abortion with Increased Peripheral NK Cells (말초혈액자연살해세포가 증가된 반복유산 환자의 탈락막자연살해세포의 발현)

  • Yeon, Myeong-Jin;Yang, Kwang-Moon;Park, Chan-Woo;Song, In-Ok;Kang, Inn-Soo;Hong, Sung-Ran;Cho, Dong-Hee;Cho, Yong-Kyoon
    • Clinical and Experimental Reproductive Medicine
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    • v.35 no.2
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    • pp.119-129
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    • 2008
  • Objective: The purpose of this study was to quantify decidual $CD56^+$ and $CD16^+$ NK cell subtype population and to evaluate the correlation between decidual NK cell expression and peripheral $CD56^+$ NK cell expression in women with a history of recurrent abortion and increased peripheral NK cells. Methods: Twenty-nine women with recurrent abortion and elevated peripheral $CD56^+$ NK cell percentage who had chromosomally normal conceptus were included in this study. Thirty-two women with recurrent abortion who had chromosomally abnormal conceptus were used as controls. Distribution of $CD56^+$ and $CD16^+$ NK cells in decidual tissues including implantation sites was examined by immunohistochemical staining. The degree of immunohistochemical staining was interpreted by score and percentage. Results: There was a significant difference in decidual $CD56^+$ NK cell score ($43.6{\pm}24.5$ vs. $23.9{\pm}16.3$ P =0.001) and $CD56^+$ NK cell percentage ($42.1{\pm}11.7$ vs. $33.9{\pm}15.8$ P =0.027) between increased peripheral NK cell group and control group. However, there was no statistically significant difference in decidual $CD16^+$ NK cell score ($18.7{\pm}9.5$ vs. $13.2{\pm}39.4$ P =0.108) and $CD16^+$ NK cell percentage ($24.7{\pm}5.9$ vs. $23.4{\pm}11.7$ P =0.599). There was no significant correlation between decidual NK cell score and peripheral NK cell percentage in increase peripheral NK cell group (peripheral $CD56^+$ NK cell percentage vs. decidual $CD56^+$ NK cell score, r=-0.016, P =0.932, peripheral $CD16^+$ NK cell percentage vs. decidual $CD16^+$ NK cell score, r=0.008, P =0.968). Conclusion: This study shows that $CD56^+$ decidual NK cells are increased in decidua of women exhibiting a history of recurrent abortion with increased $CD56^+$ peripheral NK cell. There was no significant correlation between decidual and peripheral NK cell increment in increase peripheral NK cell group. This study suggests the possibility that decidual NK cells may play an important role in the immune mechanism of recurrent abortion.

Clinical Outcomes of Corrective Surgical Treatment for Esophageal Cancer (식도암의 외과적 근치 절제술에 대한 임상적 고찰)

  • Ryu Se Min;Jo Won Min;Mok Young Jae;Kim Hyun Koo;Cho Yang Hyun;Sohn Young-sang;Kim Hark Jei;Choi Young Ho
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.157-163
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    • 2005
  • Background: Clinical outcomes of esophageal cancer have not been satisfactory in spite of the development of surgical skills and protocols of adjuvant therapy. We analyzed the results of corrective surgical patients for esophageal cancer from January 1992 to July 2002. Material and Method: Among 129 patients with esophageal cancer, this study was performed in 68 patients who received corrective surgery. The ratio of sex was 59 : 9 (male : female) and mean age was $61.07\pm7.36$ years old. Chief complaints of this patients were dysphagia, epigastric pain and weight loss, etc. The locations of esophageal cancer were 4 in upper esophagus, 36 in middle, 20 in lower, 8 in esophagogastric junction. 60 patients had squamous cell cancer and 7 had adenocarcinoma, and 1 had malignant melanoma. Five patients had neoadjuvant chemotherapy. Result: The postoperative stage I, IIA, IIB, III, IV patients were 7, 25, 12, 17 and 7, respectively. The conduit for replacement of esophagus were stomach (62 patients) and colon (6 patients). The neck anastomosis was performed in 28 patients and intrathoracic anastomosis in 40 patients. The technique of anastomosis were hand sewing method (44 patients) and stapling method (24 patients). One of the early complications was anastomosis leakage (3 patients) which had only radiologic leakage that recovered spontaneously. The anastomosis technique had no correlation with postoperative leakage, which stapling method (2 patients) and hand sewing method (1 patient). There were 3 respiratory failures, 6 pneumonia, 1 fulminant hepatitis, 1 bleeding and 1 sepsis. The 2 early postoperative deaths were fulminant hepatitis and sepsis. Among 68 patients, 23 patients had postoperative adjuvant therapy and 55 paitents were followed up. The follow up period was $23.73\pm22.18$ months ($1\~76$ month). There were 5 patients in stage I, 21 in stage 2A, 9 in stage IIB, 15 in stage III and 5 in stage IV. The 1, 3, 5 year survival rates of the patients who could be followed up completely was $58.43\pm6.5\%,\;35.48\pm7.5\%\;and\;18.81\pm7.7\%$, respectively. Statistical analysis showed that long-term survival difference was associated with a stage, T stage, and N stage (p<0.05) but not associated with histology, sex, anastomosis location, tumor location, and pre and postoperative adjuvant therapy. Conclusion: The early diagnosis, aggressive operative resection, and adequate postoperative treatment may have contributed to the observed increase in survival for esophageal cancer patients.

Evaluating the usefulness of BinkieRTTM (oral positioning stent) for Head and Neck Radiotherapy (두경부암 환자 방사선 치료 시 BinkieRTTM(구강용 고정장치)에 대한 유용성 평가)

  • GyeongJin Lee;SangJun Son;GyeongDal Lim;ChanYong Kim;JeHee Lee
    • The Journal of Korean Society for Radiation Therapy
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    • v.34
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    • pp.21-30
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    • 2022
  • Purpose: The purpose of this study is to evaluate the effectiveness of oral positioning stent, the BinkieRTTM in radiation treatment for head and neck cancer patients in terms of tongue positions reproducibility, tongue doses and material properties. Materials and Methods: 24 cases using BinkieRTTM during radiation treatments were enrolled. The tongue was contoured on planning CT and CBCT images taken every 3 days during treatment, and then the DSC and center of tongue shift values were analyzed to evaluate the reproducibility of the tongue. The tongue dose was compared in terms of dose distribution when using BinkieRTTM and different type of oral stents (mouthpiece, paraffin wax). Randomly selected respective 10 patients were measured tongue doses of initial treatment plan for nasal cavity and unilateral parotid cancer. Finally, In terms of material evaluation, HU and relative electron density were identified in RTPS. Results: As a result of DSC analysis, it was 0.8 ± 0.07, skewness -0.8, kurtosis 0.61, and 95% CI was 0.79~0.82. To analyze the deviation of the central tongue shift during the treatment period, a 95% confidence interval for shift in the LR, SI, and AP directions were indicated, and a one-sample t-test for 0, which is an ideal value in the deviation(n=144). As a result of the t-test, the mean and SD in the LR and SI directions were 0.01 ± 0.14 cm (p→.05), 0.03 ± 0.25 cm (p→.05), and -0.08 ± 0.25 cm (p ←.05) in the AP direction. In the case of unilateral parotid cancer patients, the Dmean to the tongue of patients using BinkieRTTM was 16.92% ± 3.58% compared to the prescribed dose, and 23.99% ± 10.86% of patients with Paraffin Wax, indicating that the tongue dose was relatively lower when using BinkieRTTM (p←.05). On the other hand, among nasal cavity cancer patients, the Dmean of tongue dose for patients who used BinkieRTTM was 4.4% ± 5.6%, and for those who used mouthpiece, 5.9% ± 6.8%, but it was not statistically significant (p→.05). The relative electron density of Paraffin Wax, BinkieRTTM and Putty is 0.94, 0.99, 1.26 and the mass density is 0.95, 0.99 and 1.32 (g/cc), Transmission Factor is 0.99, 0.98, 0.96 respectively. Conclusion: The result of the tongue DSC analysis over the treatment period was about 0.8 and Deviation of the center of tongue shifts were within 0.2 cm, the reproducibility was more likely excellent. In the case of unilateral head and neck cancer patients, it was found that the use of BinkieRTTM rather than Paraffin Wax or Putty can reduce the unnecessary dose irradiated to the tongue. This study might be useful to understand of BinkieRTTM's properties and advantages. And also it could be another considered option as oral stent to keep the reproducibility of tongue and reducing dose during head and neck radiation treatments.